Provider Demographics
NPI:1346598851
Name:SPEARS, CARMEN R (LCPC)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:R
Last Name:SPEARS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14440 CHERRY LANE COURT
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707
Mailing Address - Country:US
Mailing Address - Phone:410-205-9631
Mailing Address - Fax:443-442-1569
Practice Address - Street 1:14440 CHERRY LANE COURT
Practice Address - Street 2:SUITE 208
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707
Practice Address - Country:US
Practice Address - Phone:410-205-9631
Practice Address - Fax:443-442-1569
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional